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Home My WebLink About113664 JORDAN'S TREE MOVING & MAINTENANCE INC - INSURANCE CERTIFICATE (8)OP ID: SC CERTIFICATE OF LIABILITY INSURANCE E(01/2016 V) 71T2/01 /2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fax: CONTACT NAME: PHONE FAX evC No Ext : tA1C,No): E-MAIL Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI PRODUCER CUSTOMER ID #: JORDA-2 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Jordan's Tree INSURER A:Secura Insurance Companies 22543 Moving 8r Maintenance, Inc INSURER B: Pinnacol Assurance 41190 1025 Smithfield Drive Fort Collins, CO 80524 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSIR LTR TYPE OF INSURANCE L U POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X Prof Liab X CP003250287-3 CP003250287-3 12/19/2016 12/19/2016 12/19/2017 12/19/2017 EACH OCCURRENCE $ 1,000,00 PAMAGE TO RENTEU- REMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I X I PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Prof Liab $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X A3200288 12/19/2016 12/19/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ 5,00 X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑NN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 4040726 03/01/2016 03/01/2017 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L DISEASE -POLICY LIMIT $ 1,000,00 A Equipment Floater 34UUNSR3887 12/19/2016 12/19/2017 Leased 250,00 Ded 50 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Puchasing Dept. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD